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Understanding CMS Behavioral Health Billing Guidelines: Essential Information for Providers

Medisys Compliance

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. This article provides a comprehensive overview of essential information for providers navigating CMS behavioral health billing guidelines.

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List of Documents for Ambulatory Surgery Centers (ASCs)

Medisys Compliance

Billing for Ambulatory Surgery Centers (ASCs) is tightly regulated by numerous federal as well as state-level regulatory authorities. Complete documentation will support all procedure codes your billed and will provide complete picture for payers. Pre-operative medical record documentation. Discharge documentation.

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Medicare Coverage for Chiropractic Manipulative Treatment (CMT)

Medisys Compliance

Medicare covers limited chiropractic services when performed by a chiropractor who is licensed or legally authorized to furnish chiropractic services by the State or jurisdiction in which the services are furnished. In this article, we shared coding guidelines and Medicare coverage for Chiropractic Manipulative Treatment (CMT).

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Billing for Medicare Annual Wellness Visit (AWV)

Medisys Compliance

Medicare pays a physician for an Annual Wellness Visit (AWV) service. This visit is planned to develop or update a Personalized Prevention Plan (PPP) and perform a Health Risk Assessment (HRA) which is covered once every 12 months by Medicare. Medicare also waives the AWV coinsurance or co-payment and the Medicare Part B deductible.

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Basics of Provider Enrollment for Ohio Medicaid

Medisys Compliance

The application will require you to provide information about your practice, including your tax identification number, National Provider Identifier (NPI) number, and license number. You may also need to provide documentation to support your application, such as copies of your licenses or certifications.

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Understanding Mental Health Telehealth Billing

Medisys Compliance

The provider must adhere to the telehealth regulations and guidelines established by their respective state’s licensing board. Mental health telehealth billing typically includes services such as individual therapy, group therapy, psychotherapy, medication management, and crisis intervention, among others.

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Understanding Modifiers for Mental Health Billing

Medisys Compliance

As mental health services continue to evolve, it is crucial for mental health professionals and billing specialists to have a thorough understanding of the modifiers used in mental health billing. It is similar to the 95 modifier and is used to ensure proper billing and reimbursement for telehealth services under Medicare.